Oral tongue and floor of mouth cancer: lines of therapy

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5 standard-of-care settings across 4 lines and 1 biomarker subgroup. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.

Line	All comers
Screening, prevention and diagnosis	2
Locally advanced	1
Advanced, first line	1
Other settings	1

Screening, prevention and diagnosis

Subgroup	Setting	Approach	Products and trials	Guideline	Evidence
All comers	Diagnosis and staging	Biopsy, MRI or CT of the tongue and neck to measure depth of invasion and nodes, chest imaging or PET-CT for advanced stage, and dental assessment before radiotherapy.	PET/CT	NCCN Guidelines: Head and Neck Cancers	92
All comers	Prevention	Tobacco, alcohol and betel quid cessation; treatment of leukoplakia and erythroplakia; oral examination in high-risk people.	Smoking cessation in cancer patientsAlcohol reduction, pricing and cancer warning labelsOral cancer visual screening		32

Locally advanced

Subgroup	Setting	Approach	Products and trials	Guideline	Evidence
All comers	Locally advanced (T3 to T4 or node-positive)	Resection with neck dissection and free-flap reconstruction, then postoperative radiotherapy, or cisplatin chemoradiation for extranodal extension or positive margins.	IMRT / IGRT (modern external beam)CisplatinChemoradiation (chemoradiotherapy, CRT)	NCCN · Category 1 (chemoradiation for extranodal e…	93

Advanced, first line

Subgroup	Setting	Approach	Products and trials	Guideline	Evidence
All comers	Recurrent or metastatic	Pembrolizumab alone or with platinum-fluorouracil (KEYNOTE-048); oral metronomic methotrexate-celecoxib where resources are limited.	PembrolizumabKEYNOTE-048MethotrexateOral metronomic chemotherapy vs intravenous cisplatin (Tata Memorial)Recurrent or metastatic head and neck squamous cell carcinoma	NCCN · Category 1	98

Other settings

Subgroup	Setting	Approach	Products and trials	Guideline	Evidence
All comers	Primary treatment (T1 to T2, clinically node-negative)	Partial glossectomy or floor-of-mouth resection with at least 5 mm margins and elective neck dissection (Tata Memorial trial); sentinel node biopsy as an alternative in small tumours.	Elective vs therapeutic neck dissection in node-negative oral cancer (Tata Memorial)Sentinel lymph node biopsy	NCCN · Category 1 (elective neck dissection)	83

Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.